Table of Contents

Release Highlights

RCM Enhancements

Enhanced Auto-Posting for BCBS Texas

What's New: We've enhanced the auto-posting feature to accommodate the new format update from BCBS Texas. This enhancement enables the system to accurately handle ERAs that do not include an Allowed Amount.

Why it Matters: The absence of the Allowed Amount in ERAs often led to partial postings after processing only one or two claims, necessitating manual intervention to complete the postings. This update automates and completes the posting process, regardless of ERA format changes.

Who it's For: This update is crucial for billing teams and financial administrators managing ERA postings from BCBS Texas.

How to Use: To post an ERA, navigate to the Billing section, select 'Managed EOB's, choose 'New Remit' from the dropdown menu for ERAs, and proceed to 'Create Payment' from the Clearing House Files. Successful postings will be confirmed with a green checkmark, while errors will be indicated by a red X in a popup, enhancing your operational workflow.

New Unbilled Report for Outpatient Settings

What's New: An "Unbilled For Outpatient Report" has been developed specifically for outpatient settings, designed to identify instances where billable forms have been completed without an associated service order.

Why it Matters: This report is crucial for ensuring that all potential revenue from outpatient services is captured and billed appropriately. It helps healthcare providers identify services that have not yet been billed.

Who it's For: This tool is invaluable for billing and financial administrators who are tasked with ensuring all billable services are billed and maximizing revenue from outpatient services.

How to Use: To access the report, navigate to Billing > Reports and look for the “Unbilled for Outpatient” report. You can use filters such as service date, service facility, and level of care to customize the report output. The report can be exported for further analysis or integrated into daily billing operations to address any discrepancies immediately.

New History Tracking for Service Orders on Census

What's New: We have introduced a new "View History" button for Service Orders within the Census interface. This feature enables users to track the entire history of how Service Orders were entered into the Census, detailing whether entries were made automatically or manually by specific users.

Why it Matters: This feature brings a new level of transparency and accountability to the management of Service Orders. It allows for a detailed view of the origin and evolution of each order, which is critical for auditing, resolving discrepancies, and understanding service management workflows.

Who it's For: Ideal for administrators, audit teams, and anyone involved in managing or reviewing Service Orders. This tool helps ensure that all service entries are accurately documented and easily verifiable.

How to Use:

1. Navigate to the Service: Access the specific service area within your system.

2. Open a Service Order: Select and open any service order you wish to review.

3. Click the View History Icon: Located on the service order page, this icon allows you to access the historical log.

4. Review the History Details:

   • Action Type: See whether the service order was created, modified, or deleted.

   • Timestamp: Check the date and time of each action.

   • User Identification: Identify the user who initiated the action. If the service order was automatically added, it will display the relevant user’s email (either the one who created the authorization for inpatient services or who signed the form for outpatient services).

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   • Automatic Addition Indicator: A green "A" beneath the "Created" label indicates that the service order was added automatically.

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Enhancement to Auto-Billing Process in Outpatient Services

What's New: We've enhanced the auto-billing process used in outpatient services. Previously, a provider would perform a service for a patient and fill out a form, which when signed, triggered the creation of a service order automatically added to the census. Now, not only does the form trigger the service order, but it also remains linked to that service order, enhancing traceability and data integrity.

Why it Matters: This improvement ensures that each form stays associated with its corresponding service order throughout the service management and billing cycles. This linkage is crucial for future functionalities, such as detailed reporting and analysis, allowing us to examine specific actions taken on the form in relation to the service order.

Who it's For: This update is particularly beneficial for billing teams and healthcare providers who rely on accurate and efficient billing processes. It aids in tracking the full lifecycle of patient services and enhances the ability to audit and analyze healthcare delivery.

How to Use:

• Automatic Linking: The linking of the form to the service order is fully automated. There is no action required from your side to initiate this process.

• Viewing Linked Forms: To see which form is linked to a service, simply navigate to the Census page, click on the service order, and observe the "Billable Forms" column where the linked form will now be listed.

Patient Portal Enhancement

Additional Verification for New Patient Portal Users

What's New: New users of the patient portal are now required to verify their last name and date of birth before system access is granted. This follows the initial email verification and adds an additional layer of security, further safeguarding user information.

Why it Matters: This added verification step fortifies our defenses against unauthorized access, ensuring that only verified users can proceed to set up their accounts. It's an essential enhancement that significantly boosts the security of our patient portal.

Who it's For: This update is crucial for new users setting up their patient portal accounts. It also benefits all users by strengthening the security measures that protect their personal information.

How to Use: Upon your first login with a default password, you will be prompted to enter your last name and date of birth. This information must be accurately provided to proceed to the Reset Password Screen and continue the account setup process. For subsequent logins, only your email and password will be required, simplifying access while maintaining robust security.

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